Value of transrectal ultrasonography in Crohn's disease

Outryve, Marc J. Van; Pelckmans, Paul; Michielsen, Peter; Maercke, Y. M. Van

doi:10.1016/0016-5085(91)90064-r

Cited by 89 publications

(50 citation statements)

References 17 publications

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“…13 This technique provides adequate imaging of the rectal wall and anal sphincter and of intersphincteric fistulas and their relationship to the anal sphincters. 14,15 However, the limited field of view is a considerable inconvenience with this approach, precluding use of endosonography to assess primary superficial, suprasphincteric, and extrasphincteric tracks or secondary extensions. The advantages of MR imaging include multiplanar imaging and a high degree of soft-tissue differentiation, which show the fistulous track in relation to the underlying anatomy in a projection relevant to surgical exploration.…”

Section: Discussionmentioning

confidence: 99%

Role of magnetic resonance imaging in evaluation of perianal fistulas

2016

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Section: Discussionmentioning

confidence: 99%

Role of magnetic resonance imaging in evaluation of perianal fistulas

2016

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“…Most of the time with ES, fistulous pathways appear as an ill-defined, hypoechogenous zone, sometimes with centered air bubbles (hyperechogenous spots) [27,29,30,[32][33][34]. Supra-or extra-sphincterpathways can be difficult to detect because they are located outside the exploratory fields of the probe [30].…”

Section: Visualisation Of the Fistulous Pathway(s)mentioning

confidence: 99%

“…En EE, les trajets fistuleux prennent le plus souvent l'aspect d'une zone hypo6chog6ne et mal limit6e, parfois centr6e par des bulles d'air (spots hyper6chog6nes) [27,29,30,[32][33][34]. Les trajets supra ou En IRM, les trajets fistuleux sont le plus souvent ais6ment identifiables.…”

Section: Visualisation Du(es) Trajet(s) Fistuleuxunclassified

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L’imagerie dans la maladie de Crohn anopérinéale

et al. 2000

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Imaging in anal Crohn's disease RI~SUMI~Longtemps considOrOe comme secondaire et peu contributive, l'imagerie en proctologie a beaucoup Ovolu6 ces dix derniOres ann6es et contribud ~ amdliorer la prise en charge des troubles de la continence anale et des suppurations anorectales. En particulier, l'Ochographie endocavitaire (EE) et l'imagerie par r6sonance magnOtique (IRM) prennent une place grandissante dans le cadre de la maladie de Crohn anopOrinOale (MAP). Elles ne sont pas indiqu6es de fagon systOmatique mais s'avOrent utiles voire indispensables dans les situations difficiles : suppuration complexe et/ou multi-opOr6e, retard de cieatrisation ou persistance d'un dcoulement postopdratoire, suspicion ou notion av6r6e de troubles de la continence, douleurs anorectales inexpliqu6es. L'IRM semble globalement plus fiable que I'EE dans le repOrage des orifices primaire(s) et secondaire(s), des trajets fistuleux et des collection(s). Cela prurient de sa meilleure rOsolution en contraste et de la possibilit6 d'une analyse tridimensionnelle sachant que de nombreuses amOliorations techniques runt encore amdliorer ses performances. Toutefois, I'EE est une technique fiable et bien codifi6e pour l'dvaluation de l'appareil sphinctdrien. En outre, elle prOsente l'avantage par rapport I'IRM d'etre facile d'acc~s, bun march6, de courte dur6e et simple ~ mettre en oeuvre. Finalement, ces deux techniques semblent eompl6men-takes mais, s'il faut choisir, faire appel ~ un radiologue ayant une excellente connaissance de l'anatomie anorectale et de la maladie de Crohn importe actuellement davantage que le choix de la technique. ABRI~VIATIONS : MAP : maladie de Crohn anop6rin6ale.EE : 6chographie endocavitaire. IRM : imagerie par r6sonance magndtique. SUMMARY Considered for a long time as a secondary matter with little contribution of its own, imaging in proctology has much evolved during the last decade and has contributed to improve the management of faecal incontinence and anorectal sepsis. Especially, endosonography (ES) and magnetic resonance imaging (MRI) play an increasing role in the anoperineal forms of Crohn's disease (APCD). They are not systematically indicated but they turn out to be usefid and even indispensable in difficult situations: complex and~or multi-operated suppuration, healing delay or persistence of discharge after operation, suspicion or observation of faecal incontinence, unexplained anorectal pain. Overall MRI seems more reliable than ES in the detection of primary and secondary opening(s), fistulous pathways and collection(s). This results from better contrast resohttion and the possibility of tridimensional analysis, keeping in mind that numerous technical improvements will keep ameliorating its performances. ES, however, is a reliable and well codified technique for the evahmtion of sphincters. In addition, it has the advantage over MRI of being easy to access, cost-effective and fast and easy to perform. Finally, these two techniques seem to be complementary but, if one has to make a choice, selecting ...

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“…Crohn's dis ease is probably the most intensively exam ined, and several well-designed trials have been published. EUS was shown to be consis tently accurate in diagnosing fistulae and ab 49 scesses -in some studies more accurate than CT [90][91][92][93], Questions still remain, however, as to whether this procedure will have a major impact on the clinical outcome, as other methods of detection including rectal exami nation are relatively accurate in distinguish ing perianal disease from inflammatory bowel disease.…”

Section: Colon and Rectummentioning

confidence: 99%

Endoscopic Ultrasonography: Current Indications and Applications

Jaffe

1995

Dig Dis

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Endoscopic ultrasonography is an exciting new field, with a rapidly expanding literature describing a wide variety of applications. Despite remarkable advances in the field, a number of crucial issues remain to be resolved. These include the limited availability of educational programs for training, enormous initial start up costs for centers related to the cost of equipment and the lack of interchangeability with processors, paucity of outcomes research studies, and technical limitations of the currently available devices. The aim of this article is to review the basic principles, instrumentation, applications, and potential problems related to endoscopic ultrasound and to attempt to define the realistic role for this tool in contemporary medical practice.

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Value of transrectal ultrasonography in Crohn's disease

Cited by 89 publications

References 17 publications

Role of magnetic resonance imaging in evaluation of perianal fistulas

Role of magnetic resonance imaging in evaluation of perianal fistulas

L’imagerie dans la maladie de Crohn anopérinéale

Endoscopic Ultrasonography: Current Indications and Applications

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